Does the USCCB allow for the use of abortifacients in cases of rape?

by Jamie Manson

Grace on the Margins

Although I am loath to talk about something as traumatizing and violent as rape as if it were an ideological issue, given the national conversation taking place about abortion in cases of rape and incest, it is important to continue the conversation in the pages of NCR.

At its convention this week, the Republican National Committee will put forward a platform calling for a constitutional ban on abortion that makes no exceptions for rape or incest. And vice presidential nominee Paul Ryan said recently in a television interview that abortion is immoral and should be illegal "regardless of the method of conception."

Ryan's statement came in the same interview where he grudgingly agrees that "rape is rape," effectively recanting his previously held position that one can distinguish "forcible rape" from other kinds of rape. If you watch the video, you may note his tone is as callous as the language he used to describe sexualized violence as just another "method of conception."

As much as Missouri Rep. Todd Akin has been vilified for expressing his now-infamous lesson in "legitimate rape," at some level we must be grateful for his lack of an internal filter. If not for his candor, the convictions held both by the RNC platform and Ryan might never have come to light quite so clearly.

Several dark truths about the conservative views of rape, women's bodies and abortion were revealed by Akin's weird science. But perhaps the grimmest of all is Akin's belief that he had found a litmus test by which we can decide whether a rape truly happened or whether it was a false claim. By Akin's reasoning, if a woman didn't get pregnant from the assault, she truly was forcibly raped. However, if she did conceive, then we have reason to believe she is either making a false claim or deep down, truly wanted the sex act.

While Akin may trace his beliefs back to his ultraconservative Presbyterian Church in America roots (a church that is distinct from the mainline Presbyterian Church U.S.A), Paul Ryan grounds his belief in the Roman Catholic tradition. Unfortunately, for Ryan, the church's position on abortion in cases of rape and incest might not be as clear-cut as he would like.

Ryan and other Catholics who like to profess their ideas about abortion in the case of rape would do well to consult with Catholics who actually deal, often on a daily basis, with women (and undoubtedly men) who are victims of rape. A great starting point would be those who work in trauma units in Catholic hospitals.

In their invaluable "Special Report: Emergency Contraception," the Catholic Health Association takes on the topic of emergency contraception for victims of sexual assault. The issue does an excellent job of debunking the myth that the emergency contraception medication like Plan B is an abortifacient. The report was published in January 2010, two years before the battle over the Health and Human Services mandate ignited a firestorm of debate over whether, among other issues, President Barack Obama would be forcing Catholic institutions to pay for so-called abortifacients like Plan B.

Many bishops, Catholic commentators and other conservative voices continue to argue that the HHS mandate's provision of Plan B would force church institutions to violate their consciences because it can potentially cause an abortion. But a closer look at the USCCB's "Ethical and Religious Directives for Catholic Health Care Services" suggests that even the U.S. bishops support the use of "medications" on victims of rape that seem to work in precisely the same way that Plan B does:

"Compassionate and understanding care should be given to a person who is the victim of sexual assault. Health care providers should cooperate with law enforcement officials and offer the person psychological and spiritual support as well as accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization."

Although the bishops never name specific medications, it is Plan B that can "prevent ovulation, sperm capacitation, or fertilization." As I have written previously in NCR, Plan B releases a synthetic version of the hormone progesterone called progestin, which thickens cervical mucus, making it more difficult for sperm to enter the uterus. The drug can also stop the ovaries from releasing an egg. If an egg has already been released, Plan B can slow down the movement of the egg. By slowing down both the egg and the sperm, it prevents fertilization. (Both IUDs and the controversial emergency contraception drug ella work in a similar way.)

The bishops and most pro-lifers have argued that Plan B also makes the lining of the uterus inhospitable to the implantation of a fertilized egg, which is why they believe it acts as an abortifacient. In their special report, the Catholic Health Association offers scientific evidence for why this isn't the case, the strongest argument being that a woman can get pregnant if she uses Plan B more than three days after intercourse takes place.

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The bishops must, at some level, understand this science, since they support the use of medications that "prevent ovulation, sperm capacitation, or fertilization" on women who are victims of sexualized violence. They are allowing these women to use Plan B as emergency contraception. Although they argue that emergency contraception cannot be used if conception has already happened, the hard, scientific truth is that there is no test to prove when conception takes place.

A pregnancy test can only come up positive after a fertilized egg implants into the endometrium that lines the uterus and sends hCG, also known as the pregnancy hormone, into the bloodstream. Just because an egg is fertilized doesn't necessarily mean it will develop into an embryo. Implantation takes place approximately seven days after fertilization, if it happens at all. Scientists estimate that, at a minimum, two-thirds of fertilized eggs fail to implant.

The USCCB's directive concludes by teaching, "It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum." Of course, many in the pro-life movement, including many bishops, argue that Plan B does precisely this. But by agreeing to the use of Plan B in victims of rape, the bishops have, in effect, agreed with the Catholic Health Association that this pill does not act as an abortifacient.

Regardless of how the bishops wish to spin their own teachings, I am glad their directive exists and is put into practice at many Catholic hospitals around the country. Although limited, it demonstrates, at the very least, some level of reason and compassion for female victims of rape. And it is a step beyond the thinking of Catholic men like Ryan and, of course, Rick Santorum, who famously said women who are impregnated as the result of rape should "make the best of a bad situation" and "accept this horribly created ... gift" from God.

Since emergency contraception like Plan B only works within a few days of a sex act, victims of sexual assault who wait to seek medical attention would not fall under the USCCB's provision. They would have to settle for Santorum's solution, which is "to embrace her and to love her and to support her and get her through this very difficult time."

That may be well and good for friends and family of men like Ryan and Santorum, but for most Catholics in this country, the idea of not allowing a woman the right to make decisions for her own, victimized body would only violate her for a second time. The best way to love and support a victim of sexualized violence is to restore her dignity and sense of self by allowing her to make the decision about what is right and good for her body and spirit.

For some women, that may mean choosing to accept her pregnancy; for others, it will not. In an act of rape, a woman is violently forced into submission against her will. She should never be forced, against her will, to submit to the theological convictions of other men.

[Jamie L. Manson received her Master of Divinity degree from Yale Divinity School, where she studied Catholic theology and sexual ethics. Her columns for NCR earned her a first prize Catholic Press Association award for Best Column/Regular Commentary in 2010.]

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